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With the number of confirmed coronavirus cases in Ottawa now tracking above 1,030, including 42 deaths — with both metrics still growing — perhaps now is not the time to embrace optimism.

Yet, after conversations Friday with a leading microbiologist and one determined entrepreneur, it’s difficult not to feel a little more comfortable about how this pandemic will finally play out.

Marc Desjardins is the head and regional lead of the division of microbiology for the Eastern Ontario Regional Microbiology Laboratory, which serves 16 hospitals in the region from Pembroke to Cornwall. The lab in the past few weeks has tripled its capacity for doing COVID-19 tests to 1,132 per day. That represents about half the testing done in the greater Ottawa area, including the provincial lab and Bio-Test Laboratory.

“We can accommodate the amount of testing that needs to be done,” Desjardins said, adding that his regional lab was running at just 50 per cent to 60 per cent of capacity.

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His biggest roadblock: the availability of specialty swabs used to collect samples of the virus. “Right now, swabs are limiting factor,” Desjardins said in reference to upping the number of tests from the hospitals and local assessment facilities such as the Brewer Park arena.

The world’s dominant supplier of swabs, Copan, is headquartered in the Lombardy region of Italy. There are also a half-dozen other manufacturers listed on Health Canada’s approved list, but all are experiencing shortages. Even so, the country’s labs have managed to scrounge enough supplies to nearly double the number of daily tests from a month ago.

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Paul Lem, CEO and founder of Spartan Bioscience, doesn’t have an issue with swabs. His problem is that he just can’t expand quickly enough. In the past few weeks, Lem has secured orders for more than two million COVID-19 test cartridges from Ontario, Quebec, Alberta and the federal government. Along the way he obtained Health Canada approval for his technology and organized a deal with a high-volume contract manufacturer in Toronto. This will allow him to bump up Spartan’s production of test kits to several hundred thousand per week by July. Capacity would escalate from there.

“There are only five of us worldwide who make portable test kits,” Lem said, “and we are all swamped.”

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Nor does there appear to be an end to the demand for his company’s DNA-analyzer, dubbed the Spartan Cube. Barring unexpected technical hiccoughs, governments for the foreseeable future will purchase whatever Spartan can make. After that, Lem intends to start selling COVID-19 test kits to corporations and, eventually, for export. Lem does not foresee a problem with the supply of swabs, which are made by contract manufacturers locally — L-D Tool & Die — as well as in Toronto. The swabs are customized for the Cube and incompatible with other test kits.

The additional testing capacity bodes well for Canada’s re-emergence from economic lockdown, a transition that will depend mightily on accurate COVID-19 tests to identify those who have the virus and isolate them. Testing will be combined with contact tracing and continued social distancing where necessary.

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But, even with the recent push to add testing capacity, will it be enough to give us sufficient knowledge about this elusive virus?

Theresa Tam, Canada’s chief public health officer, said this week the national target should be about 60,000 tests per day, roughy triple what it is today. This would include the full range from lab and point-of-care tests for the COVID-19 virus to serological tests that would screen blood for antibodies. That target looks to be a stretch for the country, certainly during the next few months. But bottlenecks of key ingredients should eventually be resolved, unless the spread of the virus really gets out of control in the United States.

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On the plus side, the Ottawa Valley’s testing capacity already matches Tam’s target on a per capita basis, which augurs well.

A national capacity surge to 60,000 tests per day is a reasonable benchmark, according to a recent study by Harvard University researchers, published earlier this month by Science journal. The study offers intriguing insight into how the virus will behave over the next few months, depending on what kind of testing and social distancing we do.

The researchers, led by Stephen Kissler and Christine Tedijan, studied two coronaviruses that were “close genetic cousins” of SARS-CoV-2, the virus that causes COVID-19, and tracked their behaviour through multiple seasons.

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https://science.sciencemag.org/content/sci/early/2020/04/14/science.abb5793.full.pdf

The study concluded there would have to be “sustained, widespread surveillance” of the U.S. population to assess how much physical distancing would be necessary in the short term and to prevent longer-term resurgences. The researchers envisaged multiple periods of physical distancing as the population gradually builds up immunity.

In analyzing the research, Harvard professor Ashish Jha concluded the U.S. would have to at least triple the number of tests to more than 500,000 per day, which would correspond to about 57,000 per day in Canada. These would include tests for the virus and antibodies alike.

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The authors also offered the hope that, if serological tests revealed that many more people than expected had been infected, but showed no symptoms, then the periods of physical distancing might be reduced. Much would depend on whether those who test positive for the virus — whether they showed symptoms or not — developed immunity and for how long.

Again, this reinforces the importance of testing.

Health Canada has approved 14 companies, including Spartan Bioscience and U.S. rivals Cephied and Abbott Laboratories, for COVID-19 tests under emergency authorization. No firm has yet been approved for serological tests, though roughly a dozen have applied. Spartan is not one of them — its products handle only DNA tests. However, Desjardins’ lab is working on a solution to test for COVID-19 antibodies. The U.S. Federal Drug Administration has approved more than 60 test-kit manufacturers under its emergency-use authorization, including four specializing in antibody tests.

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Tests alone will not make it safe to fully re-open provincial economies. Employing a small army of workers to trace the contacts of people who test positive is another key to containing the spread of the virus. When Wuhan — the original epicentre of the coronavirus — went into lockdown in January, it assigned more than 9,000 to the labour-intensive task of tracking the spread. That was about one for every 1,000 residents.

Coincidentally, Ottawa Public Health says it has anywhere between 55 to 115 workers doing case and contact management: one-tenth Wuhan’s intensity, though it’s difficult to know whether the data is comparable.

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The more data health agencies compile across Canada, the more we’ll know about how the virus is circulating and whether parts of the country are actually developing significant immunity.

Certainly provinces have been affected in sharply different ways. The influence of Quebec’s early March spring break — two weeks earlier than in most other provinces — is well known. The return later in March of hundreds of thousands of snowbirds from the southern U.S. likely also contributed to the spread of the virus, particularly in Ontario and Quebec and, to a lesser extent, in Alberta.

B.C. witnessed an early outbreak of coronavirus across the border in Washington State, so its residents may have been more cautious earlier. Certainly B.C. — along with Saskatchewan, Manitoba and New Brunswick — have the lowest incidences of COVID-19 per capita and are closest to re-opening parts of their economies.

Even so, it’s little wonder many Canadians are still nervous about the idea of re-opening provincial economies. The coronavirus that causes COVID-19 has from the beginning displayed a disturbing ability to surprise us in a bad way. And there is much we still don’t know. Marc Desjardins and Paul Lem are doing their parts to change that.